This K01 project aims to enhance the candidate's research career through mentored research and training. The candidate has a PhD in Occupational and Environmental Health, and considerable experience in agricultural health and safety. His short-term goals include conducting the proposed K01 research, leading data analyses in similar Iowa projects, and competing for two R01 awards. His long-term goals include establishing strong lines of research in injury epidemiology and intervention effectiveness. Given his background and recent faculty appointment, he is well positioned to become an independent investigator. The University of Iowa provides an outstanding research environment and experienced mentors (Drs. Craig Zwerling, Kelley Donham, Johannes Ledolter, Robert Ohsfeldt). This study has two hypotheses: 1) The Finnish farmers who are members of the Occupational Health Service (OHS) have lower injury rates, respiratory disease rates, and claim costs compared to non-members, and 2) Severe injuries are associated with demographic, income, and farm characteristics. Hypothesis 1 is tested through a retrospective cohort study, measuring whether the 2002 claim rates and costs differ between OHS members and propensity- score matched non-members. Longitudinal methods (Generalized Estimating Equations, time series) measure differences in incidence rates and trends over time. Hypothesis 2 is tested through a case-control study that identifies risk factors for severe (>[unreadable]1500) injuries (those 20% of cases that represent 79% of the insurace costs). Both analyses are based on a large, well-defined cohort (N=98,437 in 2002) and extensive data on injuries (N=6812) and occupational diseases (N=464). Agriculture remains one of the most hazardous industries in the US and effective inverventions are needed. This study evaluates a well- established agricultural OHS intervention. The results have great importance for similar efforts in Iowa and elsewhere. This study addresses three NORA priority areas and four Healthy People 2010 priority areas.